BCN Advantage Classic (HMO-POS)
$42.20 /month
Monthly Premium
$0.00
Annual Deductible
899
Drugs Covered
1
States Served
Top Covered Drugs
Most popular medications covered by this plan, ordered by national search frequency. Click any drug to see exact copay, restrictions, and alternatives.
| # | Drug Name | Type | Tier | 30-Day Copay | |
|---|---|---|---|---|---|
| 1 | Fluvoxamine maleate | Brand | Tier 3 | 0.2% coinsurance | Details |
| 2 | NOVOLOG insulin aspart | Brand | Tier 3 | 0.2% coinsurance | Details |
| 3 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | 0.3% coinsurance | Details |
| 4 | Isosorbide Dinitrate | Brand | Tier 3 | 0.2% coinsurance | Details |
| 5 | Lenalidomide | Brand | Tier 5 | 0.3% coinsurance | Details |
| 6 | Neomycin Sulfate | Brand | Tier 2 | $7.00 | Details |
| 7 | Dextrose and Sodium Chloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 8 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 2 | $7.00 | Details |
| 9 | Prochlorperazine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 10 | Venclexta Venetoclax | Brand | Tier 5 | 0.3% coinsurance | Details |
| 11 | FARXIGA DAPAGLIFLOZIN | Brand | Tier 3 | 0.2% coinsurance | Details |
| 12 | Exemestane | Brand | Tier 4 | 0.3% coinsurance | Details |
| 13 | SOMAVERT pegvisomant | Brand | Tier 5 | 0.3% coinsurance | Details |
| 14 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 3 | 0.2% coinsurance | Details |
| 15 | VARIVAX Varicella Virus Vaccine Live | Brand | Tier 3 | 0.2% coinsurance | Details |
| 16 | Clarithromycin | Brand | Tier 3 | 0.2% coinsurance | Details |
| 17 | Trumenba meningococcal group B vaccine | Brand | Tier 3 | 0.2% coinsurance | Details |
| 18 | VALPROIC ACID | Brand | Tier 3 | 0.2% coinsurance | Details |
| 19 | Mefloquine Hydrochloride | Brand | Tier 2 | $7.00 | Details |
| 20 | Bupropion Hydrochloride SR SR bupropion hydrochloride | Brand | Tier 3 | 0.2% coinsurance | Details |
Showing 20 of 899 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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